Contribution of Community Health Workers in the Management of Malaria, Acute Respiratory Infections and Diarrhea in Children in Mali from 2010 to 2024

Résumé fourni par la source

In Mali, community health workers (CHWs) were introduced in 2010 to implement Essential Community Care (ECC). This strategy aims to reduce high mortality rates (infant: 51.8‰; juvenile: 46.0‰) that exceed the targets of Sustainable Development Goal (SDG) 3.2 (25‰). Mortality is primarily caused by malaria (24%), pneumonia (11%), and diarrhea (8%), in a context of chronic shortages of skilled personnel. This study evaluated the outcomes and effectiveness of CHWs in managing these childhood illnesses. A cross-sectional mixed-methods study was conducted from September 2022 to August 2025. Quantitative program data from 2010 to 2024 were extracted from the district health information system (DHIS2). The study covered the first five regions in Mali to implement Essential Community Care (ECC), involving 4,230 Community Health Workers (CHWs) and 415 key stakeholders. Data were collected via questionnaires and analyzed using SPSS v.25.0 and R software. The majority of CHWs were women (68.24%) and were between 28 and 38 years old (57.85%). Between 2010 and 2024, community health workers (CHWs) managed 2,429,438 cases of malaria (annual average: 269,938; 12.03% of all cases), 520,439 acute respiratory infections (ARIs) (annual average: 57,827; 6.89%), and 325,316 cases of diarrhea (annual average: 36,146; 14.19%) in the study areas. Satisfaction rates were 95% within the community and 67% among healthcare workers. CHWs demonstrate significant effectiveness in managing malaria, ARIs, and diarrhea. Although their role is essential and well-regarded by the community, ARIs coverage remains lower than that for other illnesses. Strengthening supply chains and supervision is crucial to maximizing their impact on reducing infant mortality in Mali.

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